Incidence of Acute Exacerbations Among Patients With Fibrotic Interstitial Lung Disease in the United States
Speaker(s)
Yang J1, Ide J2, Olson A2
1Boehringer Ingelheim, Bryn Mawr, PA, USA, 2Boehringer Ingelheim, Ridgefield, CT, USA
Presentation Documents
OBJECTIVES: Acute exacerbations (AEx) in interstitial lung disease (ILD) are rapid deteriorations of pulmonary function, which are unpredictable and associated with poor prognosis. Diagnosis relies on a combination of radiological and clinical findings. Currently, there is lack of robust incidence estimates of AEx episodes among the ILD population in the US. We leveraged a large US healthcare database to estimate the incidence of AEx in ILD patients.
METHODS: This analysis is a retrospective cohort study leveraging the Optum® Market Clarity database from 01 January 2016 through 30 September 2022. The study population comprised adult patients newly diagnosed with fibrosing ILD with at least 12-month continuous enrollment before the first ILD diagnosis. Diagnostic criteria for identifying AEx episodes were developed based on the International Working Group’s criteria for AEx in idiopathic pulmonary fibrosis (IPF) and the need for high-dose steroid therapy. The incidence and underlying causes of AEx were evaluated, stratified by the underlying fibrotic ILD types (i.e., IPF vs. non-IPF ILD).
RESULTS: The study cohort comprised 215,214 patients newly diagnosed with fibrosing ILD, of which 8,734 (4.1%) had IPF and 206,480 (95.9%) had non-IPF ILD. The mean age of the study cohort was 67.5 years and 45.1% were male. The incidence rate of AEx for the study cohort was 2,538 cases per 100,000 person-years. The incidence rate of AEx was 25% higher in patients with IPF compared to patients with non-IPF ILD, with respective rates of 3,144 and 2,508 cases per 100,000 person-years. Among all observed AEx episodes following ILD diagnosis, 69.8% and 30.2% were considered triggered and idiopathic (i.e., of unknown cause), respectively.
CONCLUSIONS: The study estimated the incidence of AEx among patients with ILD and demonstrated a significant proportion of AE episodes were triggered by an event, such as respiratory infection. Future assessment of the burden associated with AEx is warranted.
Code
CO145
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)